Endoscope



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ENDOSCOPE 3 Sheets-Sheet 1 Filed Sept. 16, 1963 July 19, 1966 F, 1WALLACE 3,261,350

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July 19, 1966 F. J. WALLACE ENDOSCOPE 5 Sheets-Sheet 5 Filed Sept. 16,1963 United States Patent O 3,261,350 ENDOSCOPE Frederick J. Wallace,New York, N.Y., assignor to American Cystoscope Makers, Inc., PelhamManor, N .Y., a corporation of New York Filed Sept. 16, 1963, Ser. No.308,954 3 Claims. (Cl. 12S-6) This application is a continuation-impartof application Serial No. 305,304, filed August 29, 1963.

This invent-ion relation to endoscopic instruments for examination ofinternal body orifices, and more particularly relates to laryngoscopesand bronchoscopes which utilize optic fibers for illumination of thelarynx and bronchi.

An endoscope must meet limitations of size and shape dictated by theanatomical structure of the orifice in which it is to be used. Also, anendoscope must provide for light, vision and operating instruments orhigh frequency electrodes. For precision in diagnosis or otherprocedure, a fine, brilliant image that is accurate in regard to bothcolor and definition is essential to the operator. Within the relativelysmall lumen or space inside the tubular portion of known endoscopes,there is a complete electrical circuit of which a lamp is a part. Thelamp circuit requires an insulated conductor or wire to carry currentfrom a contact near the proximal end, to the lamp frequently located atthe distal end. The circuit must function perfectly under water and mustnot be affected by other solutions during sterilization, a requirementmost diicult to fulfill in any electrical structure. While theinstruments are water-tight when they leave the factory, due to the factthat they must be opened for the replacement of lamps, their ability toexclude moisture is almost entirely dependent upon the care exercised bythe user in again sealing the instruments.

In known endoscopic instruments most premature burning out of lampsresults from attempts to obtain unusually brilliant illumination. Theextent of illumination is limited by the filament of the lamp itself. Itis the practice to make use of a current regulator and observe the lampfilament closely while gradually increasing the current. The limit ofsafe current is reached when the definite reddish tint of the lampsuddenly becomes white. Further increase in illumination by increasingthe current beyond this point results in premature burning out of thelamp. Once the lamp burns out it is necessary to remove it, thusintroducing the possibility of the problems described above.

Problems also arise from the disinfection -of parts of the endoscopecontaining lamps or lenses. It is not practicable to boil or autoclaveany part of the endoscope which contains lamps. The usual chemicaldisinfectants may not be used or leaks and short circuits in the wiringmay follow. As a result it is necessary to use special disinfectantlmethods and solutions in cleaning known endoscopes.

It is an object of the present invention to provide means forilluminating internal orifices which means provide significantlybrighter illumination than was heretofore possible and may be sterilizedby boiling, autoclaving or chemicals without deleterious results.

It is another object of the present invention to provide endoscopicinstruments having illuminating means with an expected life, equivalentto that of the rest of the instrument, which means do not requiremaintenance or replacement of parts in normal use.

It is still another object of the present invention to provideparticular endoscopic instruments utilizing as an illuminating means abundle of optic fibers which may be shaped at its distal end toconfigurations especially adapted to the particular use of theinstrument.

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It is another object of this invention to provide a fiber optic bundlefor the illumination of internal orifices which is in a form rigidenough for insertion into such orifices.

It is yet another object of this invention to provide endoscopicinstruments for the examination of the larynx and bronchi which providea high level of illumination.

Further objects as well as advantages in the present invention will beapparent from the following description and the accompanying drawings,in which:

FIGURE l is a side elevational view of a laryngoscope utilizing therigid light carrying sheath of the present invention;

FIGURE 2 is an elevational view of the proximal end of the laryngoscopeof this invention taken generally along lines 2-2 of FIGURE l;

FIGURE 3 is a longitudinal cross-sectional view of the rigid lightcarrying sheath of this invention partly broken away for convenience;

FIGURE 4 is an end view taken generally along lines 4-4 of FIGURE 3;

FIGURE 5 is a transverse cross-sectional view taken generally alonglines 5--5 of FIGURE 3;

FIGURE 6 is a transverse cross-sectional View taken generally alonglines 6 6 of FIGURE 3;

FIGURE 7 is a side elevational view of the rigid light carrying sheathof the laryngoscope of this invention;

FIGURE 8 is a side elevational view lof a bronchoscope utilizing therigid light carrying sheath of this invention;

FIGURE 9 is a longitudinal cross-sectional View of the bronchoscope ofthis invention partly broken away for convenience;

FIGURE 10 is an end view of the bronchoscope of this invention takengenerally along lines 10-10 of FIG- URE 9;

FIGURE l1 is a transverse cross-sectional View taken generally alonglines 11-11 of FIGURE 9;

FIGURE l2 is a transverse cross-sectional view taken generally alonglines 12-12 of FIGURE 9.

The objects of this invention may be accomplished by forming anendoscope tubular member from two concentric, coaxial rigid tubes. Theconcentric tubes may be circular in cross-section but for someapplications are preferably slightly elliptical. For some applicationsit is desirable to taper the concentric tubes. A bundle containing alarge number of optic fibers is placed lin the annular space between thetwo tubes.

The proximal end of the optic fiber bundle is formed into a solid rodwhich is of a suitable configuration, preferably cylindrical, forcoupling to a source of light.

Because endoscopes are shape-d to conform to the orifice being examined,the distal end of the bundle may be formed into one of a variety ofshapes. A preferred shape is that of -an annu-lus substantiallycoextensive with the ends of the concentric tubes. Preferably the endsof the fiber bundle are optically polished to provide better lightdissemination and a protective lens may be placed over the polished endof the bundle, if desired. Using an annular distal configuration, lightis transmitted through the bundle to provide high intensity, coldillumination in an `annular pattern at the distal end, permitting readyobservation of internal areas. If desired, the distal end of the bundlemay be adapted to illuminate an internal orifice by forming the fibersinto a solid rod or other shape.

High intensity illumination is possible using the present invention.Intensities up to 2,000 foot candles or more at a working -distance ofone-half inch and up to 400 foot candles or more at four inches :may beobtained by connecting the device to a fiber optic light source, forinstance, by ymeans of a fiber optic light carrying bundle. Typicallythe illumination produced by the optic liber bundle is fifteen timesgreater than that produced by an incandescent lamp commonly used in same`size of endoscope.

Other features of the present invention are the elimination of wires andthe elimination of rotating contacts on the instruments which werenecessary in prior art instruments in order to provide electricalconnections for the internal lamp circuit. The present invention may be.made `applicable to all types of endoscopic equipment, particularlyexamining, operating and catheterizing endoscopes. A particularadvantage of the present invention i-s the adaptability of theinstrument to small size, for instance, for use in an infant cystoscope.

Rigid endoscopes having annularly disposed fiber optics may be preparedby the following procedure. First, using the method described in theapplication of Lawrence E. Curtiss, Serial No. 76,868, filed December19, 1960, continuous strands of fiber optics are wound on a Mylar(polyethylene terephthalate) sheet whi-ch is disposed around la drum. Aseach successive layer of fibers is laid on the drum, a layer ofthermosetting resin is placed upon it. The resin is allowed to dry butis not cured; thus it remain tacky but does not become hard and stiff.The sheet is then cut parallel to the axis of the cylinder, and a fiatsheet of Mylar having well oriented fibers is obtained.

Second, the inner tube of the endoscope is brought into contact with thefiat sheet, and the flat sheet is rolled onto the inner tube in an evennumber of revolutions sufiicient to produce the thickness of the annularbundle that is desired. `Because the resin that was applied is tacky,the sheet sticks readily to the tube, and successive convolutions stickto each other.

Third, the inner tube and optic bundle are inserted in the outer tubewhich i-s shorter than the inner tube and the fibers used. The ydistalends of the fibers are coextensive with the distal ends of both innerand outer tubes. The proximal end is formed into -a rod by pulling thefibers together. I'f necessary a solvent is used to soften the resin.After forming, the rod is inserted through a terminal fitting whichsupports it, and epoxy resin is added to the rod end and also to theannular distal end. Finally the entire assembly is baked to cure theresin and produce a hard, rigid endoscopic tube.

Where a bend is to be produced in the tube, the fibers may be insertedas above and the bend made after the outer tube is applied, but beforebaking. The presence of the fibers between the two tubes aids inmaintaining the tubes concentric. The resin is soft enough to permit thebundle to bend without breaking the fibers.

Turning now to the drawings, the laryngoscope embodiment of thisinvention is shown in FIGURES 1-7. Laryngoscope 18 is comprised of rigidlight carrying sheath 12, handle 14 and telescopic eyepiece 16, as bestshown in FIGURE 1. Rigid light carrier 12 is further comprised of metalsheath 18 which is biased at its distal end 20 and formed into shoulder22 at its proximal end. Shoulder 22 contains recess 24 into which areinserted upper split ring 26 and lower split ring 28. At their proximalends split rings 26, 2S are encircled by annular mounting ring 30 whichis connected to upper split ring 26 by bolts 32. Annular ring 33 ispressed into the proximal end of ring 30 and has the same size innerdiameter as inner tube 60. Mounting bracket 34 is connected to mountingring 38 and is a-dapted to receive sleeve 36 which slides on mountingbracket 34 and may be secured in position by thumb screw 38. Mountingarm 48 is pivotally connected to sleeve 36 and serves to supporttelescopic eyepiece 16. Breath deflector 42 is supported in mountingar-m 40 and arranged for connection to a source of gas (not shown).

Sleeve 44 is connected to lower split ring 28 and mounting ring 30, andis adapted to receive and support jack 46. Jack 46 contains recess 48into which spring 56 is inserted which coacts with a correspondingrecess 52 on connector 54 to removably couple jack 46 to flexible light4 carrier 56 which may have a jack, recess and spring similar to thosedescribed.

Disposed within rigid light carrier 12 are outer tube 58 and inner tube66 coaxial with outer tube 58 and defining an annular space 62therewith. Optic fibers 64 are disposed within the annular space 62 andare substantially coextensive at their distal end with the distal endsof outer tube 58 and inner tube 60. The proximal end `of inner tube 60is coextensive with the proximal end of upper split ring 26 and lowersplit ring 28. Outer tube 58 is shorter than inner tube 68 and endsshort of jack 46. The difference in length between the tubes is providedso that the proximal ends of optic fibers 64 may be gathered intoproximal end bundle 66 which is formed, as described above, into a hardsubstantially cylindrical rod which is supported inside jack 46. Theproximal end of bundle 66 is optically ground and is protected by glassplate 68 from mechanical damage. lhe distal end portion 70 of opticfibers 64 is formed into a substantially annular ring and hardened bythe use of resins, as described above. As seen in FIGURE 4, rigid lightcarrier 12 is substantially elliptical at its distal end but issubstantially circular at its proximal end, FIGURE 5 showing a typicaltransitional conformation of the light carrier between the twopositions.

As is best shown in FIGURE 6, handle 14 is removably connected to rigidlight carrier 12. Winged staybolt 72 threadably engages tapped channel74. Arcuate portion 76 of handle 14 engages upper and lower split rings26, 28, and arcuate member 78 is removably brought into contact withupper and lower split rings by manipulation of staybolt 72. Springs 77(FIGURE 3) urge member 78 into the open position 79 shown in phantom.

In operation rigid light carrier 12 is inserted into the larynx of thepatient with the aid of handle 14. The rigid light carrier is connectedto a light source by means of liexible light carrier 56, and telescopiceyepiece 16 is rotated into position for view down the length of therigid light carrier. Focusing of the telescopic eyepiece may beaccomplished by manipulation of knurled ring 8f). To prevent fogging ofthe lenses of the telescopic eyepiece by the patients exhaled breath, asource of gas, such as air under moderate pressure, may be connected tobreath defiector 42.

The bronchoscope embodiment of this invention is shown in FIGURES 8through l2. Bronchoscope 188 is comprised of rigid light carrier 162 andtelescope 164. Rigid light carrier 182 further is comprised of outersheath 106 which is biased at its distal end 108 and has rim 110attached thereto which aids in the smooth insertion of the bronchoscopeinto the body orifice. At its proximal end outer sheath 188 is connectedto annular mounting member 112. Sleeve 114 is connected to mountingmember 112 and is in turn connected to and supports jack 116. Jack 116has a recess 118 for receiving spring 12@ which coacts with acorresponding recess 122 in connector 124 to removably couple jack 116to a flexible light carrier 126. The flexible light carrier is connectedto a source of light (not shown) and may at its end portion have asimilar jack, recess and spring for coacting with connector 124.

First annular ring 128 and second annular ring 13G encircle annularmounting member 112, aid in supporting sleeve 114, and provide accessfor the insertion of various conduits, (not shown), such as air, oxygenand exhaust conduits. Insert 132 is connected inside and adjacent theproximal end of annular mounting member 112 and forms the proximal endsupport for the inner tube as will be described below.

Disposed within outer sheath 186 are outer tube 134 and inner tube 136defining an annular space 138 between them. Optic fibers 141B aredisposed in the annular space. The distal ends of the optic fibers aresubstantially coextensive with the distal ends of outer tube 134 andinner tube 136. The proximal ends of optic fibers 14@ are gathered andformed into a hard, substantially cylindrical rod 142, the end of whichmay be optically ground and protected by glass plate 144. The distal endportion 146 of optic fibers 140 is similarly formed into a `ring whichis, however, substantially circular in configuration.

The transistion of the bundle of optic fibers from substantially annularto a rod-like form is facilitated by the inner tube 136 beingsubstantially longer than the outer tube 134, thus providing gatheringspace for the optic fibers. Inner tube 136 is substantially coextensivewith the proximal end of insert 132, while the proximal end of outertube 134 stops on the distal side of sleeve 114. The gathering of thesubstantially annularly disposed optic fibers into rod-like form is bestshown in FIG-- URE 12.

In operation the bronchoscope is inserted into the bronchus of thepatient and the rigid optic fiber light carrier is coupled to a sourceof light through use of a exible light carrier. The telescope may thenbe mounted on the rigid light carrier with stem 148 and objective lens150 extending beyond distal end 108, and gases such as oxygen, etc., maybe connected. The bronchi of the patient are thus brightly illuminated,aiding in the thorough examination and diagnosis of their condition.

The terms and expressions which have been employed are used as terms ofdescription and not of limitation, and there is no intention in the useof such terms and expressions of excluding any equivalents of thefeatures shown and described or portions thereof, but it is recognizedthat various modifications are possible within the scope of theinvention claimed.

What is claimed is:

1. In an endoscopic instrument for examining interior portions of thethorax comprising a cylindrical endoscopic sheath and telescopicinspection means, the improvement comprising a rigid light carrierconforming to the internal shape of the endoscopic sheath and furthercomprising an outer tube, an inner tube defining an elongated cavitytherewith, said outer and inner tubes being mounted in and extendingfrom adjacent the proximal end to adjacent the distal end of said sheathand a plurality of optic fibers disposed within said cavity andextending about and along substantially the entire length of said tubes,said optic fibers being bonded together and substantially rigid fromend-to-end thereof, the proximal end portions of said optic fibers beingformed into a rigid rod and adapted for connection to an external lightsource, whereby the portions of the .thorax may be brilliantlyilluminated thereby aiding diagnosis and treatment.

2. A laryngoscope Vcomprising an elongated conical endoscopic sheathwhich is substantially cylindrical at its proximal end and elliptical atits distal end, first and second split rings connected to the proximalend of said sheath, an annular mounting ring encircling the proximalportions of said split rings and being connected thereto, a firstmounting member connected to said annular ring, a second mounting memberslidably connected to said first mounting member, a third mountingmember rotatably connected to said second mounting member, a telescopiceyepiece connected to said third mounting member, a breath deectorconnected to said third mounting member in spaced relation to saidtelescopic eyepiece; a substantially cylindrical sleeve connected .tosaid first split ring and said annular mounting ring, a jack connectedto said sleeve and having a channel therethrough; an outer tubeconforming to the internal configuration of said sheath and beingcoaxial therewith, an inner tube coaxial with said outer tube and saidsheath and forming an annular space with said outer tube, a plurality ofoptic fibers disposed within said annular space, the distal ends of`said optic fibers being substantially coextensive with the distal endsof said inner and outer tubes and being formed into a solid annulus, theproximal ends of said optic fibers being formed into a substantiallycylindrical solid rod and disposed within said channel and supported bysaid jack, whereby said optic fibers are adapted for coupling to anexternal source of light and are thereby adaptable to illuminate thelarynx; and a handle connected to said first and second split rings.

3. A bronchoscope comprising an elongated cylindrical endoscopic sheathhaving a proximal and a distal end, an annular mounting member connectedto said Sheath adjacent said proximal end, first and second annularmounting rings disposed about said mounting member, a sleeve inserted insaid mounting member and said first and second mounting rings adjacentthe proximal ends thereof and forming a channel therewith, a jackconnected to said sleeve and forming a continuation of said channel, athird annular mounting ring inserted within said mounting memberadjacent the proximal end of said mounting member; an outer tubedisposed within said sheath and being coaxial therewith, an inner .tubedisposed within said outer tube and defining an annular space therewiththe proximal end of said inner tube being substantially coextensive withthe proximal end of said third mounting member, said outer tube beingshorter than said inner tube, a plurality of optic fibers disposedwithin said annular space, the distal ends of said optic fibers beingsubstantially coextensive with the distal ends of said inner `and outerrtubes and being formed into a solid annulus, the proximal ends of saidoptic fibers being formed into a substantially cylindrical rod and beingdisposed within said channel, and adapted for connection to an externalsource of light; and a telescope adapted to be connected to saidendoscopic sheath and inserted therethrough, whereby examination anddiagnosis of the bronchi may be accomplished.

References Cited by the Examiner UNITED STATES PATENTS 3/1941 Brown128-6 5/1963 Hett l286

1. IN AN ENDOSCOPIC INSTRUMENT FOR EXAMINING INTERIOR PORTION OF THETHORAX COMPRISING A CYLINDRICAL ENDOSCOPIC SHEATH AND TELESCOPICINSPECTION MEANS, THE IMPROVEMENT COMPRISING A RIGID LIGHT CARRIERCONFORMING TO THE INTERNAL SHAPE OF THE ENDOSCOPIC SHEATH AND FURTHERCOMPRISING AN OUTER TUBE, AN INNER TUBE DEFINING AN ELONGATED CAVITYTHEREWITH, SAID OUTER AND INNER TUBES BEING MOUNTED IN AND EXTENDINGFROM ADJACENT THE PROXIMAL END TO ADJACENT THE DISTAL END OF SAID SHEATHAND A PLURALITY OF OPTIC FIBERS DISPOSED WITHIN SAID CAVITY ANDEXTENDING ABOUT AND ALONG SUBSTANTIALLY THE ENTIRE LENGTH OF SAID TUBES,SAID OPTIC FIBERS BEING BONDED TOGETHER AND SUBSTANTIALLY RIGID FROMEND-TO-END THEREOF, THE PROXIMAL END PORTIONS OF SAID OPTIC FIBERS BEINGFORMED INTO A RIGID ROD AND ADAPTED FOR CONNECTION TO AN EXTERNAL LIGHTSOURCE, WHEREBY THE PORTIONS OF THE THORAX MAY BE BRILLIANTLYILLUMINATED THEREBY AIDING DIAGNOSIS AND TREATMENT.